Pharm Comm Exam 1 Flashcards
State the components of the APhA’s code of ethics or the pharmacist
- Respect - is the covenantal relationship between the patient and pharmacist
- Promotes - the good in every patient in a caring, compassionate, and confidential manner
- Respects - the autonomy and dignity of each patient
- Acts - with honesty and integrity in professional relationship
- Maintains - professional competence
- Respects - the values and abilities of colleagues and other health professionals
- Serves - individual, community, and social needs
- Seeks - justice in the distribution of health resources
Recognize the organization which address needs for healthcare professionals and students to work towards “cultural competence”
• The Office of Minority Health - CLAS document
o (Division of US Dept. Health and Human Services)
o Some portions mandated other recommended
• Joint Commission- accrediting standards
o Hospitals and healthcare systems
• American Association of Medical Colleges
o Standards, continuing education, etc.
• Accreditation Council for Pharmacy Education (ACPE)- curriculum standards
• Health care schools- training and curriculum
o Medical, pharmacy, nursing, etc.
• Institute of Medicine (IOM)- report
• Other associations/organizations/sources- statistics, resources, policies, competencies, task forces, committees, meetings, etc.
o Various pharmacy and medical associations
o Pharmacy: American College of Clinical Pharmacy (ACCP), American Association of Colleges of Pharmacy (AACP), ACPE, The American Society of Health-System Pharmacists (ASHP) and The American Pharmacists Association (APhA)
o Sources: US Census Bureau, Diversitydata.org, Kaiser Family Foundation, National Center for Health Statisticso
Understand the Office of Minority Health’s Culturally and Lingustically Appropriate Services (CLAS) standards and goal to decrease health disparities
Who:
• Health care settings that receive federal funds
• Adopted by Joint Commissions- organizations they accredit must followà pass or fail
• Issued by US Dept. Health and Human Services
What:
• 14 standards intended to inform, guide and facilitate
• Standards 1-3: Culturally competent care
• Standards 4-7: Language access services
Goal:
• Standards 8-14: Organizational supports for cultural competence
• Only 4 Mandated portions: include language, linguistic and communication standards
Goal:
• Contribute to the elimination of racial and ethnic health disparities and to improve the health of all Americans.
Explain how OBRA ‘90, including the components that govern how pharmacists interact with patients
Who:
• Organizations who receive federal paid reimbursement
• Incorporated in state law and organizational mission statements
What: • Counsel ALL patients and lower costs when possible 3 Main Components: • ProDUR o Review entire drug profile before dispensing o Detect potential drug therapy problems o Duplication o Drug-Disease contraindications o Drug-Drug interactions o Incorrect dosage o Incorrect duration o Drug-Allergy Interactions
• Counseling o Discuss drug therapy o Name and description o Dosage form, route and duration o Special directions and precautions o Common side effects and adverse effects o Self monitoring techniques o Proper storage o Refill information o Missed dosed action
• Documentation
o “Reasonable effort” to obtain, record and maintain patient specific information
o Name, address, and telephone number
o Age and gender
o Significant disease states
o Know allergies and/or drug reactions
o Comprehensive list of medications and relevant devices
o Pharmacist’s comments about the individual’s drug therapy
Why:
• Save gov’t money US gov’t pays about 40-50% of health care costs
• Medicaid, Medicare, DOD, Prisons, federal employees
Explain HIPAA and it’s relationship between interactions with pharmacists and patients
- Provide pt.’s access to their own health care information
- Better protection against unauthorized use and disclosure of PHI pt. confidentiality
- Evolution of technology
- Privacyà seamless care no matter where patient goes
- Studies/projects have to be de-identifiedà less information as possible is to be used when possible
- No unwarranted tapping’s of data
List situations in the community pharmacy with potential for breach of confidentiality
Telephone communication Patient counseling Refill request at the intake window Position of the prescription pickup bins Provision of pharmacy records
Identify the visionaries who led the clinical pharmacy and pharmaceutical care movement
o 1989 – Hepler and Strand
• Clinical pharmacy represented transition in pharmacists seeking self-actualization and full achievement of professional potential
• Appeal to pharmacists to accept mandate of preventing drug-related morbidity and mortality
• Necessary philosophy of practice is “pharmaceutical care”
• Organizational system to facilitate provision of care is “pharmaceutical care system”
• Mission of pharmacy practice: provide pharmaceutical care
Describe the characteristics of clinical pharmacy and pharmaceutical care and strategies for more effective health communication
Strategies for more effective health communication
- Introduce yourself
- Verify patient or caregiver’s identity
- State the purpose of the encounter
- Use open-ended questions for new or changed prescriptions.
- Anticipate questions that patient my ask or information pt. may need to know
Clinical Pharmacy- Physician focused Pharmaceutical Care – Patient focused • Indirect pt. care • Process directed • Drug specialists • Quality of care • Mostly acute settings • Some pharmacists provide
Pharmaceutical Care – Patient focused • Direct pt. care • Caring based • Linked to desired outcomes • Quality of life o Resolution of medication related problems • Almost all settings • All pharmacists should provide
Briefly explain the findings of the Pharmacist Mutual Claims Study
~80% of the claims against pharmacies involve either the wrong drug or the wrong directions
~Most claims ate for “failure to counsel”
~Some claims involve allegations of “inadequate” or “incorrect” counseling
Differentiate between mechanical errors and intellectual errors as defined by the Pharmacist Mutual Claims Study
- Mechanical error
~Wrong drug
~Wrong strength
~Wrong directions - Intellectual
~Drug review
~Counseling
~Non bodily injury
Appreciate “open-ended” questioning as described by the Indian Health Services
What did your doctor tell you the medication was for?
How did your doctor tell you to take the medication?
What did your doctor tell you to expect?
Identify and list ways to compensate for barriers to communication in a pharmacy
- Separate consultation areas
- Separate Intake/Outtake windows
- Face pt/
- Maintain eye contact
- Create private areas
- Train staff
- Be open
- Use open-ended questions
- Avoid jargon and medical terminology
- Involve and educate the caregiver if appropriate
- Use communication needs if appropriate
- Show empathy and listen
- Highlight pt. info
- Use verbal and non verbal cues
- Call after hours or later if appropriate
Understand the Tuskegee Syphilis Study and resulting changes in guidelines for conducting research
- 1932 US Public Health Service
- Study lasted until 1972
- Conscious discrimination AND unconscious bias
- Result: Widespread mistrust of health care professionals within AA community (males in particular)
- Use extreme caution with stereotyping
Identify various cultures and sub-cultures in which pharmacist interact with on a daily basis
o Cultures • Common language • Social institutions Schools Hospitals Governments • Technologies • Values o Co/sub-Cultures • Gender • Age • Profession • Religion • Social class • Region of the country • Intelligent • Materialistic • Ambitious • Industrious • Deceitful • Conservative • Practical • Shrewd • Arrogant • Aggressive • Sophisticated • Conceited • Neat • Alert • Impulsive • Stubborn • Conventional • Progressive • Sly • Traditional • Dominant • Socioeconomic status • Disability • Sexual orientation • Religion • Health beliefs • Race • Ethnicity • Values
Define biomedical culture and how it impacts your practice
The culture of those in the biomedical field
• Then:
~ Health care provider, usually the physician, as the center focus
~ Focused predominantly on disease and treatment
~ Ignored non-biomedical treatment options
• Now:
~ Patient-centered focus
~ Focus on health, wellness, and prevention
~ Slowly it is encompassing complementary and alternative medicine, but frequently only if scientific evidence is supportive
